Ankylosing Spondylitis (AS) is an inflammatory condition which results in bony growth and fusion. It is also recognized as a form of arthritis.
Ankylosing refers to the fusion of vertebra and joints of the spine. Spondylitis refers to inflammation.
Inflammation occurs where soft tissue (ligaments/tendons) attach to the bone. Once this settles, healing takes place. This results in the formation of new bone, and ultimately fusion.
Areas affected mainly include the Sacroiliac joint and spine.
1/3 of individuals with AS are affected in other joints (shoulders, knees ankles etc)
Onset occurs during teenage years or in their twenties. 1 in 200 Men are affected and 1 in 500 women.
Signs & Symptoms
Slow gradual onset of pain
Restricted movement of lumbar spine
Restricted chest expansion measurement
Pain lingers for months
Pain is not relieved by rest
Pain decreases with exercise
Fatigue, fever, weight loss
Flattened lumbar curve
Accentuated thoracic kyphosis
Tender Achilles and plantar fascia insertions
What Causes It?
Researches are uncertain of the definite cause of AS. However, there appears to be a familial tendency. Also there is a strong association (96% of individuals with AS) with Genetic Cell Marker - Human Leucocyte Antigen B27.
How to Self Manage
See your GP for assessment, and referral to a Rheumatologist.
Confirmation may require an x-ray and/or MRI.
Once diagnosis confirmed:
Exercise (swimming and hydrotherapy can be good as they are low impact and promote mobility)
Medication (non-steroidal anti-inflammatories) to reduce pain
Posture awareness – Pilates may be helpful
Sleep with a firm mattress and a single pillow to maintain normal spinal curvatures
AS is usually managed with increased body awareness, exercise, and medication. If joints are severely affected then surgery may be indicated at a later stage.
How Physio Helps
Conduct a thorough posture analysis
Prescribe an exercise program addressing spinal mobility, encourage extension, increased breathing, and improved posture)